title: Weather and air pollutants have an impact on patients with respiratory diseases and breathing difficulties in Munich, Germany.
abstract: This study determined the influence of various meteorological variables and air pollutants on airway disorders in general, and asthma and/or chronic obstructive pulmonary disease in particular, in Munich, Bavaria, during 2006 and 2007. This was achieved through an evaluation of the daily frequency of calls to medical and emergency call centres, ambulatory medical care visits at general practitioners, and prescriptions of antibiotics for respiratory diseases. Meteorological parameters were extracted from data supplied by the European Centre for Medium Range Weather Forecast. Data on air pollutant levels were extracted from the air quality database of the European Environmental Agency for different measurement sites. In addition to descriptive analyses, a backward elimination procedure was performed to identify variables associated with medical outcome variables. Afterwards, generalised additive models (GAM) were used to verify whether the selected variables had a linear or nonlinear impact on the medical outcomes. The analyses demonstrated associations between environmental parameters and daily frequencies of different medical outcomes, such as visits at GPs and air pressure (-27 % per 10 hPa change) or ozone (-24 % per 10 μg/m(3) change). The results of the GAM indicated that the effects of some covariates, such as carbon monoxide on consultations at GPs, or humidity on medical calls in general, were nonlinear, while the type of association varied between medical outcomes. These data suggest that the multiple, complex effect of environmental factors on medical outcomes should not be assumed homogeneous or linear a priori and that different settings might be associated with different types of associations.
authors.affiliation: Institute for Emergency Medicine and Management in Medicine, University Hospital of Munich, Ludwig-Maximilians-University, Schillerstr. 53, 80336, Munich, Germany, Eva.Wanka@med.uni-muenchen.de.
authors.forename: E R
authors.initials: ER
authors.lastname: Wanka
authors.forename: A
authors.initials: A
authors.lastname: Bayerstadler
authors.forename: C
authors.initials: C
authors.lastname: Heumann
authors.forename: D
authors.initials: D
authors.lastname: Nowak
authors.forename: R A
authors.initials: RA
authors.lastname: Jörres
authors.forename: R
authors.initials: R
authors.lastname: Fischer
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000397:Air Pollution / Q000706:statistics & numerical data*; D001249:Asthma / Q000453:epidemiology*; D015984:Causality; D002648:Child; D002675:Child, Preschool; D004777:Environment; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012307:Risk Factors; D017678:Sex Distribution; D014505:Urban Population / Q000706:statistics & numerical data*; D014887:Weather; D055815:Young Adult